Individual provider Active NPI

Matthew Ryan Bawel, PHARMD

  • Pharmacist
  • Shamokin Dam, PA
National Provider Identifier
1427428853
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP449662 Issued in PA
Practice address
3819 N Susquehanna TRL
Shamokin Dam, PA 17876-9119
Phone
(570) 743-2022
NPI assigned
Sep 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP449662 PA Primary
Pharmacist 183500000X RPI009762 PA

Addresses

Primary practice location

3819 N Susquehanna TRL
Shamokin Dam, PA 17876-9119

Mailing address

3819 N Susquehanna TRL
Shamokin Dam, PA 17876-9119
Phone (570) 743-2022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP449662PAMDPharmacist
RPI009762PAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1427428853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 N SUSQUEHANNA TRL",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "178769119",
            "telephone_number": "570-743-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 N SUSQUEHANNA TRL",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "178769119",
            "telephone_number": "570-743-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAWEL",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP449662",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RPI009762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shamokin Dam, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.